title: An assessment of current clinical attitudes toward letrozole use in reproductive endocrinology practices.
abstract: OBJECTIVE
  To assess the clinical use and practice attitudes among Society for Assisted Reproductive Technology (SART) members regarding the use of letrozole for ovulation induction and infertility treatment.
  
  
  METHODS
  The SART clinic physicians were mailed a cover letter and consent form, a two-page survey, and return envelope. The surveys were returned and analyzed using descriptive statistics.
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  None.
  
  
  METHODS
  A 13-question survey.
  
  
  METHODS
  Reproductive endocrinology and infertility physicians use patterns and attitudes regarding letrozole.
  
  
  RESULTS
  A total of 77.9% of physician prescribe letrozole. Of those who do not, 32.4% cited concern about the US Food and Drug Administration warning, 35.1% cited satisfaction with current medications, 25.7% cited both reasons, and 6.8% cited no experience with letrozole. Physicians (11.5%) were unaware of the US Food and Drug Administration warning. Physicians (99.7%) were aware that ovulation induction is an off-label use of letrozole. The most common use was for ovulation induction in patients with polycystic ovary syndrome (PCOS). Physicians (14.9%) prescribe letrozole as first-line ovulation therapy prior to clomid, 47.9% use for clomid failures, and 25.7% reported use in both situations.
  
  
  CONCLUSIONS
  Most physicians surveyed use letrozole for ovulation induction despite the current US Food and Drug Administration warning. Even when accounting for nonrespondents, more than 25% of physicians indicated success with letrozole use. Questions regarding doses and clinical concerns about letrozole revealed no standardized manner of letrozole administration despite wide interest, therefore additional research is warranted.
authors.affiliation: Department of Obstetrics and Gynecology, University of Florida, College of Medicine, Gainesville, Florida.
authors.forename: Lindsay
authors.initials: L
authors.lastname: Malloch
authors.forename: Alice
authors.initials: A
authors.lastname: Rhoton-Vlasak
mesh_terms: D047072:Aromatase Inhibitors / Q000627:therapeutic use; D001291:Attitude of Health Personnel; D001294:Attitude to Health; D015897:Comorbidity; D064420:Drug-Related Side Effects and Adverse Reactions / Q000453:epidemiology; D004704:Endocrinology / Q000706:statistics & numerical data*; D005260:Female; D019538:Health Care Surveys; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007247:Infertility, Female / Q000188:drug therapy* / Q000453:epidemiology*; D000077289:Letrozole; D009570:Nitriles / Q000627:therapeutic use*; D056687:Off-Label Use / Q000706:statistics & numerical data; D010062:Ovulation Induction / Q000379:methods / Q000706:statistics & numerical data*; D010820:Physicians / Q000706:statistics & numerical data; D010818:Practice Patterns, Physicians'; D015995:Prevalence; D018456:Reproductive Medicine / Q000706:statistics & numerical data*; D018570:Risk Assessment; D014230:Triazoles / Q000627:therapeutic use*; D014481:United States / Q000453:epidemiology
chemical_list: D047072:Aromatase Inhibitors; D009570:Nitriles; D014230:Triazoles; D000077289:Letrozole
keywords: Letrozole use; ovulation induction; survey